Provider Demographics
NPI:1578936050
Name:REED-JONES, INGLISH
Entity Type:Individual
Prefix:
First Name:INGLISH
Middle Name:
Last Name:REED-JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 EAST KIRBY SUITE B-7
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-4047
Mailing Address - Country:US
Mailing Address - Phone:248-508-2004
Mailing Address - Fax:180-092-5776
Practice Address - Street 1:15 E KIRBY ST STE B-7
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-4047
Practice Address - Country:US
Practice Address - Phone:248-508-2004
Practice Address - Fax:180-092-5776
Is Sole Proprietor?:No
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI7289110Medicaid